Arterial priapism in dengue: A case report and literature review.

Arterial priapism, rare and often traumatic, is generally associated with cavernous arterial lesions. We report an unprecedented case in a 17-year-old adolescent, occurring spontaneously after severe dengue, expanding the understanding of this pathology. No similar association has been previously documented in the literature. The patient was successfully treated with conservative measures, and erections returned to normal. Dengue, by causing vascular leaks, could be a rare trigger for arterial priapism. Further studies are needed to elucidate these mechanisms and potential clinical implications.

[Purple urine bag syndrome (PUBS): about two cases at the Regional University Hospital Center (CHUR) of Ouahigouya]. / Le syndrome de la poche à urines violette: à propos de deux cas au Centre Hospitalier Universitaire Régional (CHUR) de Ouahigouya.

Purple urine bag syndrome (PUBS) is an uncommon complication of urinary tract infection. It mainly affects elderly patients with constipation, chronic urinary catheter and prolonged bed rest. Several bacteria belonging to two different groups, the group converting indoxyl urinary sulphate into indoxyl and the group alkalizing urine by the production of urease, are associated with it. We here report two cases of young patients aged 30 and 16 years, living in Burkina Faso, with uremic encephalopathy associated with severe infection and cloudy urine with purple urine bag. Unlike cases reported in the literature, our cases occurred two and four days after urinary catheterization and in young patients without constipation. Despite early antibiotic therapy, outcome was unfavorable in one patient.

Clinical, Paraclinical, and Evolutionary Profiles of Kidney Failure in Gold Miners Hospitalized in a Nephrological Service in a Sub-Saharan African Country.

Introduction. The purpose of this preliminary study is to describe the clinical, paraclinical, and evolutionary profiles of gold miner patients with kidney failure hospitalized in the nephrology and haemodialysis service in the Yalgado Ouédraogo University Hospital of Ouagadougou (CHU-YO). Patients and Methods. This was a longitudinal and descriptive study with a retrospective collection of data for the period from February 1, 2013, to March 31, 2018. Included were all gold miner patients who stayed and worked at an artisanal gold mining site for at least three months and who were diagnosed with acute or chronic kidney failure during hospitalization in the nephrology service. We collected sociodemographic, clinical, and paraclinical variables at admission and then three months later. RESULTS: We included 50 patients; all were male and the average age was 29.4 ± 7.7 years. All patients were exposed to mercury and/or cyanide for an average of 4.5 ± 2.8 years. The average consultation/referral time for patients at the CHU-YO was 25.4 ± 14.9 days. The average of creatininemia was 2338.0 ± 791.4 µmol/L. Kidney failure was acute in five cases (10%) and chronic in the remaining 45 cases or 90%. Extrarenal purification was indicated in 43 cases (86%). It was not performed in nine of the 43 cases due to lack of financial resources for patients (six cases) or death prior to the onset of haemodialysis (three cases). Thirty-two of the 50 patients in the study (64% of cases) died. CONCLUSION: Chronic kidney failure in gold miners appears to be common and late-managed. A prospective study of kidney disease and its causes at gold mining sites and surrounding areas will assess the extent of the problem in the country and better clarify the prevention of these diseases in our country.

[Epidemioclinical Profile Of Chronic Hemodialysis Patients At Tengandogo University Hospital, Ouagadougou]. / Profil Epidemio-Clinique Des Patients En Hemodialyse Chronique Au CHU De Tengandogo, Ouagadougou.

Nephrology in Burkina Faso faces many challenges, including insufficient epidemiological data. AIMS: Our study aims to describe the epidemiological and clinical characteristics of patients on chronic hemodialysis in a new hemodialysis center. METHOD: This was a cross-sectional, descriptive, monocentric study conducted in the hemodialysis unit of Tengandogo University Hospital from February 1, 2018 to January 31, 2019. RESULT: We recorded 94 patients undergoing hemodialysis for end-stage kidney disease, including 63 patients with hemodialysis incidents versus 31 patients transferred to us from other centers. The average age was 43.7 years[4-85 years]. The average age of hemodialysis was 42.5 years[4-85 years]. The average duration of hemodialysis was 1.2 years[0-12 years].The sex ratio was 2.48. The main comorbidity was high blood pressure with 63.8%. In 43.6% of cases, the cause of chronic kidney disease could not be determined. Vascular nephropathy of hypertensive origin and chronic glomerulonephritis are found respectively with 27.6% and 12.7%. The mortality rate is 23.4 per 100 people years. In 82% of cases, death occurred within the first month following hemodialysis.Young age, diagnostic difficulties and high mortality rates reveal the inadequacies of our health system and negatively affect socio-economic development. CONCLUSION: These data show the need for a kidney disease prevention program.

La néphrologie au Burkina Faso est confrontée à de nombreux défis dont l'insuffisance de données épidémiologiques. BUT: Notre étude a pour but de décrire les caractéristiques épidémiologiques et cliniques des patients en hémodialyse chronique dans un nouveau centre. MÉTHODE: Il s'est agi d'une étude transversale, descriptive, monocentrique, menée dans l'unité d'hémodialyse du CHU de Tengandogo du 1er février 2018 au 31 janvier 2019. RÉSULTATS: Nous avons enregistré 94 patients pris en charge en hémodialyse pour insuffisance rénale chronique terminale, dont 63 patients incidents en hémodialyse contre 31 patients qui nous ont été transféré à partir d'autres centres. L'âge moyen était de 43,7 ans [4-85 ans]. L'âge moyen de mise en hémodialyse était de 42,5 ans [4-85 ans]. La durée moyenne en dialyse était de 1,2 ans [0-12 ans]. Le sexe ratio était de 2,48. La principale comorbidité était l'hypertension artérielle avec 63.8%. Dans 43,6% des cas, la cause de la maladie rénale chronique n'a pas pu être déterminée. La néphropathie vasculaire d'origine hypertensive et la glomérulonéphrite chroniqueétaient retrouvés respectivement avec 27,6% et 12,7%. Le taux de mortalité étaitde 23,4 pour cent personnes années. Dans 82% des cas, le décès est survenu dans le premier mois suivant la mise en hémodialyse. Le jeune âge, les difficultés de diagnostic, le taux de mortalité élevé, révèlent les insuffisances de notre système sanitaireet affectent négativement le développement socio-économique. CONCLUSION: Ces données montrent la nécessité de la mise en place d'un programme de prévention des maladies rénales.

[Epidemiology of acute renal failure during dengue fever in the city of Ouagadougou]. / Épidémiologie de l'insuffisance rénale aiguë au cours de la dengue dans la ville de Ouagadougou.

AIM: Describe acute renal failure during dengue fever in Ouagadougou, in a context of almost nonexistent african data on the subject. PATIENTS AND METHOD: The study was cross-sectional and descriptive with a retrospective collection of data in 13 health structures. It concerned a period of 16 months. Included were suspected cases of dengue fever following the guidelines of the ministry of health and for whom an ARF was diagnosed. The acute renal failure and its severity were defined according to KDIGO's recommendations. RESULT: Sixty-seven cases (sex ratio 2.7 ; mean age 39.6±16.7 years) of acute renal failure were noted among 316 dengue fever patients, or 21.2%. The mean of serum creatinine on admission was 440.7±504.2 µmol/L. The acute renal failure severity was classified at stage 3 in 29 cases, or 43.3%. The most common etiopathogenic factors were those responsible for renal hypoperfusion in 47 cases, or 70.2%; 14 cases of brown macroscopic hematuria, or 20.9%, were observed. Nine patients, or 13.4%, were taken in conventional acute hemodialysis. Six cases of death, a lethality rate of 9%, were observed. CONCLUSION: The acute renal failure in our dengue fever patients population was very common, severe, and highly lethal. The prognosis should improve with early management. It would be even better to promote primary prevention through effective vector control.

[Anxiety and depression during chronic renal failure before end stage at the University hospital center Yalgado Ouedraogo of Ouagadougou (Burkina Faso)]. / Anxiété et dépression au cours de l'insuffisance rénale chronique avant le stade terminal au centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou (Burkina Faso).

AIM: We wanted to know the prevalence of depression and anxiety, as well as the associated factors in patients with chronic renal failure in Burkina Faso. PATIENTS AND METHODS: This was an analytical cross-sectional study conducted from February to May 2016. We included all adult patients with moderate or severe chronic renal failure. The diagnosis of anxiety and depression was made using the Hamilton scales. Identification of factors associated with both conditions required bi- and multivariate analyzes. RESULTS: The study involved 191 patients, with a mean age of 53.2±14.2 years and a sex ratio of 1.4. The prevalence of anxiety and depression was 42.4% and 66.5%, respectively. In 37.7% of cases, both anxiety and depression were noted. The mean age was 52.2±13.1 years for anxious patients and 53.5±13.3 years for the depressed. After multivariate analysis, female sex (odds ratio 2.2; adjusted P=0.014) was significantly associated with anxiety, and anxiety itself at depression (odds ratio 7.5; adjusted P<0.001). CONCLUSION: Anxiety and depression are very common during moderate or severe chronic renal failure in Burkina Faso. In view of their potentially serious consequences, there is a definite interest in their early detection by the nephrologist, especially in the female patient, and for early management.

[Hemoglobinuria in children hospitalized in Ouagadougou: short term inpatient care and prognosis]. / Hémoglobinurie chez l'enfant à Ouagadougou: prise en charge hospitalière et pronostic à court terme.

INTRODUCTION: The purpose of this study was to analyze the epidemiological, diagnostic, therapeutic and evolutionary features of hemoglobinuria in children hospitalized in the Pediatric University Hospital Charles de Gaulle, Ouagadougou. METHODS: We conducted a cross-sectional descriptive study over the period 01st July-31st December 2014. All children aged 0-15 years hospitalized in the Department of Medical Pediatrics of the Pediatric University Hospital Charles de Gaulle and diagnosed with macroscopic hemoglobinuria during the study period were enrolled. RESULTS: Thirty-eight patients were included in the study. Hospitalization rate for hemoglobinuria was 1.9%. The average age of patients was 80.8 ± 44.1 months (ranging from 21 to 168). The study involved 23 boys (60.5%) and 15 girls (39.5%). The major clinical signs were: fever (86.8%), dark urines like « coca cola ¼ (86.8%), pallor (63.2%), hepatomegaly (50%). Glomerular filtration flow was less than 80 mL/min/1.73m2 in 23 patients (69.7%); 21 patients had Glucose-6-phosphate dehydrogenase (G6PD) deficiency. The main suspected causes of hemoglobinuria were: severe malaria, bacterial and viral infections, G6PD deficiency, biliary haemoglobinuric fever. Treatments included: artemisinin derivatives, antibiotics and antipyretics. One patient underwent dialysis. CONCLUSION: Hemoglobinuria is a symptom mainly causing diagnostic problems in our context. It is a severe disorder which can result in acute renal failure (ARF).

[Cutaneous manifestations in patients on chronic hemodialysis in a developing country]. / Les manifestations cutanées chez les patients hémodialysés chroniques dans un pays en voie de développement.

Our study aims to highlight the most common skin disorders in patients on chronic hemodialysis at the University Hospital Yalgado Ouédraogo (CHU-YO) in Ouagadougou. The study, of transverse type descriptive, carried out of September 15 to December 31, 2014, is unrolled with the CHU-YO. This descriptive transversal study was conducted at the CHU-YO from September 15 to December 31, 2014. It involved patients who had been on chronic dialysis for at least 3 months. The frequency of hemodialysis sessions was one every five days. The significance level of statistical tests was defined as the probability p ≤ 0.05. Eighty-five patients (61.1% men and 38.9% women) with an average age of 42.1 years were included in the study. The mean duration of hemodialysis was 31.9 months. The success rate of biological examinations varied from 7,4 to 85,3%. Eighty patients (85,3%) had at least one cutaneous manifestation. Cutaneous xerosis (67.4%), pruritus (45.3%), and hyperpigmentation (23.2%) were the most frequent skin manifestations that may be specific of hemodialysis. Guttate hypomelanosis (11.6%), prurigo (11.6%) and folliculitis (8.4%) were the main non-specific skin manifestations. Skin involvement was frequent but did not seem related to seniority in hemodialysis. In Ouagadougou, bad hemodialysis conditions and a hot, dry environment promote such conditions, especially xerosis and pruritus. A better subvention of health care could help to reduce the prevalence of skin diseases and to improve the quality of life of our patients on chronic hemodialysis.

[Factors associated with depressive symptoms in chronic hemodialysis patients of centre hospitalier universitaire Yalgado Ouédraogo (Burkina Faso)]. / Facteurs associés à la symptomatologie dépressive chez les patients hémodialysés chroniques du centre hospitalier universitaire Yalgado Ouédraogo (Burkina Faso).

OBJECTIVE: To determine the factors associated with depressive symptoms in chronic hemodialysis patients at centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou (CHU-YO). PATIENTS AND METHODS: The study was cross sectional and descriptive, from June 2nd to July 30th, 2014. We included chronic hemodialysis patients of CHU-YO. The frequency of hemodialysis sessions was of every four to five days. The French version of Hamilton depression psychometric scale was used to assess depressive symptoms. The factors associated with depression were identified after descriptive and explanatory analysis. RESULTS: Depressive symptoms were identified in 140 of the 162 patients included in the study, or a prevalence of 86.4%. The average age of the 140 patients was 38.9±12.9years. In bivariate analysis, the risk of having depressive symptoms was 1.5 times for women, 1.7 times for patients with severe anemia, 1.5 times for hemodialysis catheter holders, 1.8 both in case of duration in hemodialysis less than six months. In multivariate analysis, gender and duration in hemodialysis were factors associated with the occurrence of depressive symptomatology. CONCLUSION: Our study confirms the high frequency of depressive symptoms in patients on hemodialysis. To improve the overall care of hemodialysis patients, we suggest routine screening for depressive symptoms and specific support.

High Prevalence of Opaline Silica in Urinary Stones From Burkina Faso.

OBJECTIVE: To underline peculiar composition of kidney stones and to propose an epidemiologic study of urinary stones in West African countries, where epidemiologic studies are scarce. Only few data are available regarding stone composition in sub-Saharan countries. Recently, a set of 100 stones consecutively removed by surgery in the Department of Urology of the University Hospital of Ouagadougou in Burkina Faso were collected for physical analysis, which provided the opportunity to obtain an epidemiologic profile of stone composition in this country. MATERIALS AND METHODS: A total of 100 stones from 64 men, 22 women, 10 boys, and four girls were analyzed by morphologic examination, infrared spectroscopy, and electron microscopy in our laboratory. The results were considered by sex and separately for adults and children. RESULTS: Sixty-five percent of the 100 stones contained calcium oxalate as the main component. Interestingly, the second main component was opaline silica (18%). Furthermore, opaline silica was identified in any proportion in 48% of the stones. The prevalence was sex and age dependent. Opaline silica was detected as the main component in 42% of the nuclei, which underlines its role as one of the main components involved in the initiation of calculi in this country. CONCLUSION: For the first time, a dramatically high occurrence of a "scarce" urinary stone component, namely opaline silica, was reported in a series of consecutive calculi from a single country. We propose that a regular consumption of clay could be the origin of this phenomenon in these populations.